BLALOCK, TRAVIS WAYNE - Licensee Information

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Last Update: Thursday, December 19, 2024 3:44 AM CST
Next Update: Thursday, December 19, 2024 12:00 PM CST

BLALOCK, TRAVIS WAYNE

This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.

Practice Address:	UNIVERSITY OF OKLAHOMA HEALTH SCIENCES 619 NORTHEAST 13TH STREET OKLAHOMA CITY OK 92037 Address last updated on 4/4/2014
Phone #:
Fax #:
County:	OKLAHOMA
License:	29309
Dated:	6/18/2012
Expires:	6/1/2015
License Type:	Medical Doctor
Specialty:	Dermatology

Status:	Inactive
Status Class:	Expired License
Restricted to:
Registered to Dispense:	NO
Medical School:	Mercer Univ Sch Of Med, Macon Ga 31207
Graduated:	5 / 2007
CME Year:	2015

Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.

All information below is entered by the licensee but not verified by the Oklahoma Medical Board.

Certifications:	AMERICAN BOARD OF DERMATOLOGY
New Patients:	Yes
Medicaid:	Yes
Medicare:	Yes

HMO/PPO:	Aetna Elect Choice Aetna HMO Aetna Managed Choice Aetna PPO Blue Cross Blue Shield-Blue Preferred Blue Cross Blue Shield-Blue Traditional Blue Cross Blue Shield-Plan 65 Select BlueChoice PPO BlueLincs HMO CIGNA PPO CommunityCare HMO, Inc CommunityCare Senior HMO Coventry Health Care National Network First Health Health Smart Preferred Care (HSPC) HealthChoice Humana ChoiceCare Medicare Blue Multiplan PPO Oklahoma Health Network PPO Pacificare Commercial HMO PacifiCare of Oklahoma, Inc Preferred Community Choice Secure Horizons HMO SoonerCare PPO UniCare Health Plans of Oklahoma United Healthcare Choice United Healthcare EPO United Healthcare HMO United Healthcare Options PPO United Healthcare POS Welcor/Sooner
Hospital Privileges:	OU Health Medical Center Oklahoma City, OK V.A. Medical Center-OKC Oklahoma City, OK

Locations:	Hours:	Languages:
UNIVERSITY OF OKLAHOMA HEALTH SCIENCES 619 NORTHEAST 13TH STREET OKLAHOMA CITY OK 92037 Phone #: Fax #:

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